Understanding Alabama's prescription drug monitoring program
The Alabama Prescription Drug Monitoring Program (“PDMP”) is a program developed to promote the public health and welfare of Alabama citizens by detecting diversion, abuse, and misuse of prescription medications classified as controlled substances under the Alabama Uniform Controlled Substances Act. Anyone who dispenses Class II, III, IV, or V controlled substances (i.e., codeine, morphine, oxycodone, hydrocodone, oxymorphone, tramadol, fentanyl) is required to report the dispensing of these drugs to a controlled substances prescription database maintained by the Alabama Department of Public Health. Mandatory reporting began April 1, 2006.
Drug Abuse and Misuse in Alabama. When taken as prescribed, prescription painkillers can help relieve acute and chronic pain. But given their potential for abuse, close monitoring and management of their use is critical to ensure better health and lower costs. A recent study by Express Scripts, a health care company that manages pharmacy benefits, found that Alabama has the highest narcotic utilization rate in the nation and the fifth highest per capita spending on narcotics (factoring in both utilization and cost-per-prescription) behind Oklahoma, Nevada, Utah, and Ohio. In 2011, the Centers for Disease Control and Prevention identified Alabama among the top 20 states in number of drug overdose deaths.
Goals of the Prescription Drug Monitoring Program. The goals of the PDMP include the following:
- To provide a source of information for practitioners and pharmacists regarding the controlled substance usage of a patient;
- To reduce prescription drug abuse by providers and patients;
- To reduce time and effort to explore leads and assess the merits of possible drug diversion cases; and
- To educate physicians, pharmacists, policy makers, law enforcement, and the public regarding the diversion, abuse, and misuse of controlled substances.
2013 Amendments to PDMP. Three bills aimed at decreasing the abuse of prescription drugs in Alabama were signed into law earlier this year. The Prescription Drug Abuse and Diversion Package included the pain management bill (HB 151) which was discussed in a recent Sirote Health Care Blog post, as well as a “doctor shopping” bill (HB 152) which will be discussed in a future post.
The Prescription Drug Abuse and Diversion Package also included a bill (HB 150) which amended the PDMP effective August 1, 2013, as follows:
- Grants the Alabama Medicaid Agency the ability to access the PDMP database and check prescription drug use by people enrolled in Medicaid.
- Allows the Alabama Board of Medical Examiners to require or obligate a physician (by regulation) to access or check the information in the PDMP database prior to prescribing, dispensing, or administering medications or as part of their professional practice.
- When reporting controlled substances prescription information to the PDMP database, entities or practitioners subject to the reporting requirements (including dispensing physicians) must now report the method of payment and third-party payor identification of the controlled substance dispensed in addition to all other required data elements.
- Physicians can now designate two employees under their supervision the authority to access the PDMP database on their behalf.
- Physicians may now self-query the PDMP database.
- Allows interoperability between the PDMP, other states, and the United States Department of Justice, and allows law enforcement to access the PDMP database in certain circumstances in order to help combat drug prescription drug abuse and diversion.
Penalty for Misuse of the Database. Any person who intentionally makes an unauthorized disclosure of information contained in the PDMP database shall be guilty of a Class A misdemeanor. Any person or entity who intentionally obtains unauthorized access to or who alters or destroys information contained in the PDMP database shall be guilty of a Class C felony.
The reports generated from the PDMP database contain confidential information, including patient identifiers, and are not public records. The information should not be provided to any other persons or entity.
Additional information about the PDMP, including Frequently Asked Questions and instructions on PDMP registration, can be found on the Alabama Department of Public Health web site.